Resource restrictions were established in many jurisdictions to maintain health system capacity during the COVID-19 pandemic. Disrupted healthcare access likely impacted early cancer detection. The objective of this study was to assess the impact of the pandemic on weekly reported cancer incidence.
This was a population-based study involving individuals diagnosed with cancer from September 25, 2016, to September 26, 2020, in Ontario, Canada. Weekly cancer incidence counts were examined using segmented negative binomial regression models. The weekly estimated backlog during the pandemic was calculated by subtracting the observed volume from the projected/expected volume in that week.
The cohort consisted of 358,487 adult patients with cancer. At the start of the pandemic, there was an immediate 34.3% decline in the estimated mean cancer incidence volume (relative rate, 0.66; 95% CI, 0.57-0.75), followed by a 1% increase in cancer incidence volume in each subsequent week (relative rate, 1.009; 95% CI, 1.001-1.017). Similar trends were found for both screening and nonscreening cancers. The largest immediate declines were seen for melanoma and cervical, endocrinologic, and prostate cancers. For hepatobiliary and lung cancers, there continued to be a weekly decline in incidence during the COVID-19 period. Between March 15 and September 26, 2020, 12,601 fewer individuals were diagnosed with cancer, with an estimated weekly backlog of 450.
We estimate that there is a large volume of undetected cancer cases related to the COVID-19 pandemic. Incidence rates have not yet returned to prepandemic levels.
Journal of the National Comprehensive Cancer Network : JNCCN. 2022 Feb 01 [Epub ahead of print]
Antoine Eskander, Qing Li, Jiayue Yu, Julie Hallet, Natalie G Coburn, Anna Dare, Kelvin K W Chan, Simron Singh, Ambica Parmar, Craig C Earle, Lauren Lapointe-Shaw, Monika K Krzyzanowska, Timothy P Hanna, Antonio Finelli, Alexander V Louie, Nicole Look Hong, Jonathan C Irish, Ian J Witterick, Alyson Mahar, Christopher W Noel, David R Urbach, Daniel I McIsaac, Danny Enepekides, Rinku Sutradhar
1ICES, Toronto, Ontario., 4Division of Biostatistics, Dalla Lana School of Public Health., 9Department of Radiation Oncology, University of Toronto, Ontario., 3Department of Otolaryngology - Head and Neck Surgery., 11Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba., 2Institute of Health Policy, Management, and Evaluation.